DESCRIPTION (Applicant's Abstract): This is a revision of a small grant application originally submitted in September, 1996. Anorexia nervosa is a serious and sometimes fatal psychiatric disorder of unknown etiology. It is often associated with significant impairment across the full range of functioning. It is often chronic and resistant to treatment. Consensus is that a multitude of factors contribute to the etiology of anorexia. Studies have been conducted which provide description of the clinical presentation and course of the disorder; however, given the relatively low prevalence rate and the complexity of this disorder, there is very limited knowledge of both the factors which put women at risk for developing anorexia nervosa and the efficacy of specific treatment modalities. The proposed study will use a structured clinical interview which assesses a range of putative risk factors for eating disorders, including anorexia nervosa. The study will contribute important data for developing an empirically based model of cumulative risks for anorexia nervosa. The study will identify specific and general risk factors for anorexia nervosa. In addition, we will be able to address the extent to which the identified risk factors have predictive value in determining treatment outcome given that our subjects will be treatment seeking individuals who will be followed for a long-term period. A secondary goal of the study is to compare the risk factors for anorexia nervosa with other eating disorders. The New a England Women s Health Project is collecting data from clinic and community cases of women with binge eating disorder and bulimia nervosa. Although these are completely independent projects, the two studies employ identical assessment procedures and the data set from the New England Women s Health Project will be available for such comparisons. A final secondary aim of the study is to compare the risk factors for the two subtypes of anorexia nervosa. The results from this study will contribute to building a more solid empirical foundation regarding the etiology of anorexia nervosa. By examining a large number of risk factors in unison, this study will provide important information regarding the relative significance of various putative risk factors. Such data will facilitate future prospective studies by narrowing and focusing such an investigation so as to make it feasible. Finally, these data will inform future efforts aimed at prevention and early intervention. Given the severity of anorexia nervosa and its resistance to treatment, such interventions may improve to be effective in reducing the rates of anorexia nervosa if they target those individuals who are at high risk based on identified risk factors.